Trajectories of Home Care Service Use among Older Swedes Affected by Severe Disease with and without Close Kin: Sequence Analysis of Nationwide Register Data

Anna C. Meyer , Institute of Environmental Medicine, Karolinska institutet
Karin Modig, Karolinska Institutet

A growing proportion of older Swedes lives at home rather than in institutional housing. Although Swedish municipalities offer publicly funded home care services, these cannot compensate for the lack of care previously given within institutions. Family members take on an increasing share of care for older individuals, leaving those without next-of-kin in a vulnerable position. With this study, we aim to describe trajectories of home care utilization among individuals experiencing severe diseases and to examine how such trajectories are associated with the presence of close kin, specifically spouses and children. This study is based on a linkage of population registers covering the entire Swedish population. We will visualize individual trajectories of granted home care hours during the time before and after experiencing a disease event. We focus on myocardial infarction, stroke, and hip fracture, which are among the most common and severe diseases in old age and often impact a person’s care needs substantially. Using sequence analysis, we will identify clusters of common trajectories and compare these between diseases. We will then employ multivariable regression models in order to examine how the presence of children or spouses is related to the consumption of home care and to which extent other sociodemographic characteristics are associated with observed patterns. Preliminary findings using the example of hip fracture indicate that sustaining a hip fracture is associated with increased utilization of home care, particularly among unmarried individuals. Individual trajectories of home care utilization are diverse, but sequence analysis is suitable to identify distinct clusters.

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 Presented in Session 88. Linked Lives: Grandparents, Parents, and Children